Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Curr Med Sci. 2020 Oct;40(5):851-857. doi: 10.1007/s11596-020-2253-6. Epub 2020 Oct 29.
Age-related macular degeneration (AMD) is the most common cause of irreversible blindness and visual impairment in individuals over the age of 50 years in western societies. More than 25 million people currently suffer from this illness in the world, with an additional 500 000 every year, approximately. It is a multifactorial ocular disease that affects the maculae due to a late-onset progressive neurodegeneration and dysfunction of photoreceptors and retinal pigment epithelium (RPE). There are many subtypes of AMD but basically two broad forms: the nonneovascular (dry, nonexudative) and neovascular (wet, exudative). Exudative AMD is the less common form (about 15%) but tends to progress more rapidly. At the moment, wet AMD is treated primarily on the basis of anti-vascular endothelial growth factor (VEGF) agents, which have led to massive improvement in the prognosis of the disease since they were first introduced. This article focuses on the latest treatment approaches to neovascular AMD. An extensive literature review was performed in order to illustrate the effectiveness of current and future anti-VEGF agents as well as the landmark clinical studies that have been carried out to establish these drugs as a gold standard in the therapy of wet AMD.
年龄相关性黄斑变性（AMD）是西方社会 50 岁以上人群中导致不可逆性失明和视力损害的最常见原因。目前全球有超过 2500 万人患有这种疾病，每年还会新增约 50 万人。这是一种多因素眼病，由于感光细胞和视网膜色素上皮（RPE）的迟发性进行性神经退行性变和功能障碍而影响黄斑。AMD 有许多亚型，但基本上有两种广泛的形式：非新生血管性（干性、非渗出性）和新生血管性（湿性、渗出性）。渗出性 AMD 是较少见的形式（约 15%），但往往进展更快。目前，湿性 AMD 主要基于抗血管内皮生长因子（VEGF）药物进行治疗，自首次引入以来，这些药物极大地改善了疾病的预后。本文重点介绍新生血管性 AMD 的最新治疗方法。为了说明当前和未来的抗 VEGF 药物的有效性，以及为将这些药物确立为湿性 AMD 治疗的金标准而进行的具有里程碑意义的临床研究，我们进行了广泛的文献回顾。
